1. HealthConnect ICD International Center for the Disabled Cohort 2 Northeast Learning Community New York City

2. ICD HealthConnect New York City Behavioral Health Addiction Recovery Services Primary Care HealthConnect Primary Care TBI- Traumatic Brain Injury

3. ICD HealthConnect Staff Ed Ross, Vice President, Behavioral HealthEd Ross, Vice President, Behavioral Health Amy Dimun, Program ManagerAmy Dimun, Program Manager Randie Kozar, Health Navigator SupervisorRandie Kozar, Health Navigator Supervisor Cat O’Neill, Nurse ExtenderCat O’Neill, Nurse Extender Elizabeth Shanks, Health NavigatorElizabeth Shanks, Health Navigator Dr. Frank Guida, EvaluatorDr. Frank Guida, Evaluator

4. About Our Program 150 clients enrolled: 320 enrollment target 150 clients enrolled: 320 enrollment target HealthConnect Priority: Cardio-metabolic Issues, Diabetes, Obesity and Smokers. HealthConnect Priority: Cardio-metabolic Issues, Diabetes, Obesity and Smokers. Focus on clients with Traumatic Brain Injury (TBI) Focus on clients with Traumatic Brain Injury (TBI) Health Navigation Services: Personal Case Manager (Health Navigator), Coordination of Care, Quarterly Doctor Visits, Reminder Calls, Health Escorts, Individualized Wellness Plans, Communication Skills. Health Navigation Services: Personal Case Manager (Health Navigator), Coordination of Care, Quarterly Doctor Visits, Reminder Calls, Health Escorts, Individualized Wellness Plans, Communication Skills. Specialist Care: Pain Management, Neurology, Diabetes Management, Gynecology, Physical Medicine and Rehabilitation. Specialist Care: Pain Management, Neurology, Diabetes Management, Gynecology, Physical Medicine and Rehabilitation. Smoking Cessation: Motivational Interviewing, NRT, Specialized Smoking Session Supervision. Smoking Cessation: Motivational Interviewing, NRT, Specialized Smoking Session Supervision.

5. Accomplishments Active Client Advisory Board Inter-disciplinary Team Meetings Motivational Interviewing Engagement 303 Total Weight Loss Client group training for NYC Marathon Cohesive Staff Smoking Cessation Success Pharmacy Linkages Decreased Medical No-Show rate Joined NYC Inter-borough RHIO

6. Successful Strategies Specialized Groups and Workshops: Wednesday Wellness Workshops for Clients and Staff NYC Walking Groups: Farmers Markets, Free City Activities, Food Shopping Excursions Farmers Market Shopping on a Budget Nutrition Demonstrations Addiction Recovery Workshops

7. Health and Wellness Activities: Diabetes Self Management, Walking Groups, Smoking Cessation, Nutrition Workshops

8. Plans for the Future  Board of Director fundraising  Supplemental grant initiatives  Health Navigation Service as part of Psychiatric Walk-in clinic